Kornimate/medical-research-clean huggingface dataset:
investigating predictive factors of diabetes occurence after duodenalpancreatectomy

Conditions: GLUCOSE METABOLISM; DIABETES; PANCREATIC ISLETS; Exocrine Pancreatic Dysfunction; Exocrine Pancreas Conditions; Exocrine Pancreatic Insufficiency; Endocrine Pancreas Disorder

Summary: regeneration of mature cells that produce functional insulin represents a major focus of current diabetes research aimed at restoring beta cell mass in patients with most forms of diabetes. the capacity to adapt in response to diverse physiological conditions during life and the consequent ability to cope for increased metabolic demands is a distinctive feature of the endocrine pancreas in the regulation of glucose homeostasis. both beta and alpha cells are dynamically regulated to continually maintain a balance between proliferation, neogenesis, and apoptosis. in this proposal, the investigators will focus on exploring key mechanism(s) that potentially regulate islet cell plasticity in altered glucose metabolic states. investigators will explore in a unique cohort of individuals who undergo duodenal pancretectomy. prior to their surgery will be performed in vivo studies (hyperglycemic clamp, euglycemic hyperinsulinemic clamp and mixed meal tests) to accurately assess glucose homeostasis parameters to classify each individual into metabolic phenotypes. then exploit the opportunity to collect pancreas samples from these patients who will be evaluated again after surgery, the investigators will determine the ability of the remnant pancreas to compensate for the acute reduction in islet mass and perform correlations between ex vivo and in vivo parameters. specifically, the patients will be subjected to incretin secretion (mixed meal), metabolic status (ogtt), insulin secretion characteristics (first and second phase responses), β-cell insulin content evaluation (arginine bolus). subsequently, pancreas samples will be evaluated for morphometry, and proteomics and gene expression analyses of islet cell samples obtain by laser capture will allow a detailed investigation of mechanisms that contribute to islet plasticity. the overall goal of this project is to investigate key mechanisms driving the ability of islet mass to adapt to diverse metabolic states. we aim to explore modifications in gene expression and proteomics and correlate them with specific metabolic phenotypes, in order to determine key regulators of islet morphology.


Eligibility criteria:
inclusion criteria: * scheduled for pancreatectomy * no diabetic and diabetic exclusion criteria: * chronic deseases * steroid therapy

Keywords: beta cell function islet cell crosstalk incretin intraislet system biomarkers mirna ncrna pancreatic exocrine endocrine crosstalk diabetes of exocrine pancreas
h2o vr for burns 2015

Conditions: Pain; Burn

Summary: this study is designed to find additional methods to reduce pain during wound care. in this study the investigators use virtual reality (a form of distraction) in addition to pain medication during a burn wound care.

this study will employ a randomized within-subjects design. there are three different conditions in this study. by randomization, the participants will experience at least two of the conditions and likely all three, depending on the number of their wound care sessions. all subjects will always receive all their usual pain medications for all treatment conditions. the three conditions are: high tech virtual reality (vrd), low tech virtual reality (nature slides), and standard wound care (no vr). the subjects will be randomly assigned to receive some portions of their wound care sessions during high tech virtual reality (vrd), some portions during low tech virtual reality (nature slides), and some portions with standard wound care, no virtual reality. the treatment orders will be randomized. after each treatment condition the investigators will ask subjects one pain question about their pain intensity during the most recent treatment condition.

Eligibility criteria:
inclusion criteria: * age greater than or equal to 18 years * compliant and able to complete questionnaires * no history of psychiatric disorder * not demonstrating delirium, psychosis or any form of organic brain disorder * able to communicate verbally * english-speaking exclusion criteria: * age less than 18 years * not capable of indicating pain intensity * not capable of filling out study measures * evidence of traumatic brain injury * history of psychiatric disorder * demonstrating delirium, psychosis or any form of organic brain disorder and associated memory problems * unable to communicate orally * receiving prophylaxis for alcohol or drug withdrawal * developmental disability * any face/head/neck injuries that interfere with the use of virtual reality equipment * non-english speaking * extreme susceptibility to motion sickness * seizure history

Keywords: vrd
invictus medical, medical cranial support device (csd) is a device safety study in infants at risk of head ulcers.

Conditions: Other Preterm Infants

Summary: while using the device as a cushion, the passive distribution of pressure over bony skull prominences of infants will protect against formation of pressure ulcers.

this study is designed to evaluate the safety of the invictus cranial support device (csd) when worn by medically stable infants within a neonatal intensive care unit (nicu), to evaluate the form, fit, and ease of use/application of the csd device (i.e., utility), as well as initial impressions of safety, by health care providers (hcps) after placing the current csd on infants for approximately six (6) hours in a nicu. specifically, this study will: * collect safety information at specified time points (baseline, 15 minutes, 1 hour, 3 hours, and 6 hours) utilizing a widely used dermal assessment tool, health assessments (temperature, pulse, respiration rate), excessive scalp sweating/moisture accumulation, and adverse events, as reflected in the table 1.0, time and events table. additional safety assessments will be performed following the final removal of the csd from the infants head. refer to table 1.0 time and events table and section 6.1. * assess the hcp's impression of likely safety and effectiveness (function assessments) of the csd based on experience working with infants in the nicu, evaluate/rate the form and fit, and evaluate/rate the ease of application of the product. * collect additional feedback (if any) on hcp's impressions of device design and usability based on experience working as a hcp in the nicu

Eligibility criteria:
inclusion criteria: 1. have a parent(s) or guardian(s) who has provided written informed consent for the patient to participate in the study. 2. be \> 30.0 weeks gestational age at time of enrollment into the study 3. be in medically stable condition within the nicu 4. be able to breathe adequately on room air without support 5. be deemed suitable (i.e., in no acute distress) for participating in the study for approximately six (6) hours, in the investigator's opinion 6. upon visual inspection have intact skin without breaks and/or lacerations of the scalp or adjacent areas where the csd will fit exclusion criteria: 1. the use of any additional respiratory support (i.e., intubation, using cpap, etc.) is required, 2. the patient has any genetic dermatological conditions 3. the patient's head size is not appropriate for the device \ 34.3 centimeters (\ 13.5 inches) 4. patient has significant medical condition(s) (e.g., encephalocele, ivh, shunt, etc.) that makes participating in the study not in the patient's best interest
hip strength and nerve palsy after the modified stoppa approach to acetabular fracture reduction and fixation

Conditions: Acetabular Fracture; Pelvic Fracture

Summary: the purpose of this prospective study is to compare hip adductor strength and obturator nerve palsy between acetabular fracture patients whose fracture was reduced and fixated using the modified stoppa approach (subjects) and pelvic fracture patients (controls) using physical strength testing, radiographs, clinical assessment, and a validated functional outcome questionnaire. the investigators' research hypothesis is that there will be less strength and higher incidence of obturator nerve palsy in patients treated with the modified stoppa approach (intervention) than in patients treated without the modified stoppa approach (controls).


Eligibility criteria:
inclusion criteria: * inclusion criteria for the subject patient population under study consists of male and female adults, at least 18 years old, who had an acetabular fracture that was treated with the modified stoppa approach. * inclusion criteria for the control patient population under study consists of male and female adults, at least 18 years old, who had acetabular fractures with similar fracture patterns as the study group that were treated with any other approach than the stoppa approach. exclusion criteria: * exclusion criteria for the subject and control patient population consist of: * patients who are non-ambulatory. * patients less than 18 years of age. * patients who do not speak english. * patients who are unable to complete their follow-up in utah.

Keywords: acetabular fracture pelvic fracture hip adductor strength obturator nerve palsy modified stoppa approach
maintenance therapy of 308-nm excimer laser therapy in patients with vitiligo

Conditions: Vitiligo; Maintenance Therapy; the 308-nm Excimer Laser; Recurrence

Summary: although vitiligo is difficult to cure, recurrences are frequent after treatment, and many patients suffer from concerns about recurrence as well as disease. psoriasis, another indication for ultraviolet radiation treatment, has been established that it can safely and effectively reduce the recurrence of psoriasis through monthly maintenance therapy. the aim of this study was to evaluate the efficacy of 308-nm excimer laser therapy for the prevention of relapse in vitiligo.

for a total period of 12 months, perform the 308-nm excimer laser treatment once a month. check for signs of enlarged vitiligo lesions at 3-month intervals for a total period of 12 months. an independent evaluator will obtain the score of vitiligo area (vitiligo extent score) from comparing clinical photographs of before registration and after the clinical trial, and judge whether vitiligo is recurred. this study is a randomized controlled trial, and the investigators plan to compare the recurrence rates of the experimental and control groups using the chi-squared test.

Eligibility criteria:
inclusion criteria: 1. patients with age of 19 years or older 2. patients of generalized vitiligo with lesions on the trunk 3. patients who had treated with the 308-nm excimer laser previously and achieved more than 75% lesion improvement 4. patients who voluntarily agreed to participate in the study exclusion criteria: 1. patients under the age of 19 2. patients with localized vitiligo and segmental vitiligo 3. patients who are in a state of physical or mental impairment to perform treatment or pregnant 4. patients with spreading of vitiligo lesions 5. patients who do not want to do thie study or who refuse to write a consent form 6. any other person deemed unsuitable for the examination at the discretion of the examiner

Keywords: vitiligo 308-nm excimer laser maintenance therapy recurrence
comparison of mesh fixation and non-fixation in etep

Conditions: Migration of Implant; Pain; Postoperative Complications; Relapse

Summary: inguinal hernia surgery is one of the most frequently performed procedures among general surgery cases. as with many open surgical methods, this repair is also performed laparoscopically. among these closed methods, the one method is laparoscopic extended total extraperitoneal repair (etep). the benefits of laparoscope include less postoperative pain and complications, faster recovery, reduced chronic pain, and recurrence rate. one of the recent debates regarding the laparoscopic technique is mesh fixation. fixation of the mesh to the cooper ligament can prevent mesh migration and consequently reduce the recurrence rate. however, it has been reported that this fixation may increase postoperative pain. several studies have reported that recurrence may be due to inadequate mesh fixation technique. in contrast, other prospective randomized studies have found relapse unrelated to mesh fixation. in the etep technique, dissection is performed in a larger area than in tep. for this reason, it can be thought that the possibility of mesh displacement is higher in the etep procedure. the purpose of this study is to confirm this idea with a prospective study. there are studies in the literature on mesh fixation related to the total extraperitoneal repair (tep) technique. however, there is no study on mesh detection in the etep technique. the aim of the study is to compare patients who underwent withmesh fixation and without mesh fixation laparoscopic etep repair in terms of clinical data such as mesh displacement and hernia recurrence, chronic pain, length of hospital stay, and postoperative complications.


Eligibility criteria:
inclusion criteria: * patients with unilateral inguinal hernias, * patients aged 18-65. exclusion criteria: * younger than 18 years, and older than 65 years, * incarcerated or strangulated inguinal hernias, * patients with bilateral inguinal hernias, * patients who are contraindicated to receive general anesthesia, * pregnancy
intensive speech motor chaining treatment for residual speech sound disorders

Conditions: Speech Sound Disorder

Summary: the goal of this randomized-controlled trial is to compare distributed treatment schedules and intensive treatment schedules in 84 school-age children with residual speech sound disorders. the main question it aims to answer is: * how does intensive and distributed treatment affect speech sound learning in residual speech sound disorder? some participants will be treated with a traditional distributed schedule of 2 sessions per weeks for 8 weeks (16 hours total), whereas others will be treated with an intensive schedule and will complete 16 hours of treatment in 4 weeks.

residual speech sound disorders are defined as speech sound disorders that persist past \~8-9 years and may lead to social, academic, and vocational limitations. thus, there is a need to investigate how treatment schedules affect speech sound learning. the overall objective of this study is to optimize a suite of theoretically motivated, high-fidelity, motor-based treatments delivered at the appropriate intensity, despite practical barriers, for the most commonly impacted rssd sounds: /ɹ, s/. our central working hypothesis, supported by our preliminary work, is that speech motor chaining is more efficacious when delivered intensively (i.e., closely spaced for a fixed number of sessions). the theoretical rationale is that increasing intensity early in treatment will mitigate erred practice between sessions, improving outcomes relative to more customary practice distributions. to test this hypothesis, children will be randomly assigned to receive a standard distributed treatment schedule or an intensive treatment schedule.

Eligibility criteria:
inclusion criteria: * must speak american english as a dominant language. * must have began learning english by at least the age of 3 years. * must be between 9;0 to 17;11 years of age. * must have reported difficulty with /ɹ/ and/or /s/ production * must pass pure tone hearing screening at 25 db at 1000, 2000, and 4000 hz. * must receive a scaled score of at least 5 on the listening comprehension and story retelling subtests of the test of integrated language and literacy skills (tills) * must receive a percentile score of 5 or below on the goldman-fristoe test of articulation-3 (gfta-3) sounds in words subtest. * must have 1 scorable response with 5+ consecutive correct /pataka/ with \> 3.4 syllables per second in the mrr-tri task of the maximum performance tasks or must demonstrate no childhood apraxia of speech (cas-only) features in both articulatory and rate/prosody domains of the procad. * must score \<40% accurate on /ɹ/ and/or /s/ probes assessing these sounds at the word level. * must express a desire to modify their speech. exclusion criteria: * must have no known history of autism spectrum disorder, down syndrome, cerebral palsy, intellectual disability, permanent hearing loss, or brain injury. * must not have current cleft palate or voice disorder.
effect of normobaric hypoxia and hyperoxia in patients with pulmonary hypertension

Conditions: Pulmonary Hypertension

Summary: pulmonary hypertension (ph) is a severe disease with a bad prognosis. however, thanks to extensive research in this field, there are more and better treatment options that allow patients to participate in recreational activities at moderate altitude or bring up the question of air-travel. still very few is known about the effects hypoxic conditions have on ph patients. the aim of this study is to investigate the effects of hypoxia in comparison to normoxia and hyperoxia on pulmonary hemodynamics in patients with pulmonary hypertension during routine right heart catheterisation. we aim to get insight into the pathophysiology of pulmonary hemodynamics under hypoxic conditions in comparison to normoxia and hyperoxia in patients with pulmonary arterial and chronic thromboembolic pulmonary hypertension compared with control patients, that are scheduled for right heart catheterisation due to dyspnea but have no ph.


Eligibility criteria:
inclusion criteria: * clinically indicated right heart catheterisation * diagnosis of pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension or control without pulmonary hypertension exclusion criteria: * hemodynamically unstable * partial pressure of oxygen \< 7.3kpa * no informed consent * pulmonary hypertension due to left heart disease, chronic lung disease or miscellaneous (groups ii, iii and v) according to galié erj 2015

Keywords: pulmonary arterial hypertension chronic thromboembolic pulmonary hypertension hypoxia hyperoxia
effect of bobath therapy on balance alterations in patients with multiple sclerosis

Conditions: Bobath Therapy; Postural Control; Virtual Reality; Home Exercise Program

Summary: to evaluate the effects of a foot treatment to improve balance according to the bobath concept in people with multiple sclerosis, comparing it with treatment through home exercise and with treatment from bobath concept combined with the use of virtual reality. as a secondary objective, we seek to know the state of the art of bobath therapy in multiple sclerosis.


Eligibility criteria:
inclusion criteria: 1. age: over 18 years old. 2. have a diagnosis of multiple sclerosis, according to mc donald criteria at least 6 months before the start of the intervention. 3. be able to walk independently in a closed environment with or without technical aids, having a maximum score of 6.5 on the expanded disability status scale or edss, according to its acronym in english: 6.5= constant bilateral help (canes, crutches or braces) to walk about 20 meters without rest. the usual functional system (fs) is equivalent to combinations with more than two fs of grade 3+. exclusion criteria: 1. participants who are not able to understand instructions, 2. participants who are in a clinically unstable situation or who have risk factors or concomitant pathologies of the musculoskeletal system, neurological or cardiovascular, which make it difficult to carry out the treatment. 3. participants with visual disturbances or severe upper limb involvement who therefore have difficulty using the vr glasses or performing reaching exercises with them.
acupuncture and computer-based training to improve attention deficits in patients after stroke

Conditions: Stroke

Summary: the purpose of this study is to determine whether acupuncture and computer-based attention training can be combined for more effective post-stroke attentional deficits.


Eligibility criteria:
inclusion criteria: * admitted to inpatient stroke rehabilitation within six months after first-ever stroke * mild cognitive impairments (attention performance tap \> 1 standard deviation below mean age-matched norm in at least one subtest). * conscious, stable physical condition and signed informed consent of patient. exclusion criteria: * severe visual and/or hearing problems * inability to follow instructions (moca) * disorders of speech and instruction comprehension (tested with a modified token-test) * severe visual and/or hearing problems * pre-existing mental disorders - pregnancy
endobronchial valves in persistent air leak

Conditions: Malignant Neoplasm of Lung

Summary: because an endobronchial valve is a one-way inspiratory airway blocker, it is hypothesized that it could be also used for controlling persistent air leaks while maintaining the drainage of secretions. the u.s. food and drug administration approved in october 2008 the spiration valve system designed to control air leaks in the lung that persist after lung surgery. this prospective observational study aims to evaluate the efficacy and safety of spiration endobronchial valves in a prospective series of consecutive patients with a prolonged persistent air leak after anatomic surgical resection for cancer.

persistent air leak (pal) is independently associated with prolonged hospital length of stay, decreased patient satisfaction, increased morbidity or postoperative complications, and adds significantly to the cost. the management of air leaks is primarily preventive and therefore starts in the operating room with surgical techniques that can minimize the occurrence of post-operative air leaks, such as the creation of pleural tents or use of suture line glues or sealants. notwithstanding some patients will after a lung resection have pal. any minimal invasive method that helps to increase our ability to treat (reduce and/or stop) the air leak in these latest cases carries an enormous clinical as well as cost-saving potential. bronchoscopic occlusion of a segmental or subsegmental bronchus using endobronchial valves is such a less invasive method which has shown in case reports to interrupt an air leak.

Eligibility criteria:
inclusion criteria: * prolonged (≥10 days postoperative) persistent air leak refractory to conventional treatments (such as prolonged drainage and/or chemical pleurodesis). * anatomical lung resection such as segmentectomy, (bi)lobectomy or sleeve lobectomy. * air leak after antero/posterolateral thoracotomy or video-assisted thoracoscopy (vats). * type of air leak : expiratory. * size of air leak : any. exclusion criteria: * prolonged air leak \<10 days postoperative. * pneumonectomy or none-anatomical lung resection. * lung resection for another indication than cancer. * previous reintervention or previous heimlich valve for this air leak. * empyema
a study to determine number of patients who develop high ammonia levels after receiving recombinant erwinia asparaginase

Conditions: Hematopoietic and Lymphatic System Neoplasm; Acute Lymphobkastic Leukemia

Summary: this study evaluates the incidence of symptomatic hyperammonemia (high ammonia levels) in patients being treated with recombinant erwinia asparaginase.

primary objective: i. to determine incidence of patients who develop hyperammonemia secondary to recombinant erwinia asparaginase. ii. to characterize patients at risk for hyperammonemia secondary to recombinant erwinia asparaginase. outline: this is an observational study. patients undergo blood sample collection, complete surveys, and have their medical records reviewed on study.

Eligibility criteria:
inclusion criteria: * followed by pediatric hematology/oncology * receiving recombinant erwinia asparaginase for treatment of malignancy exclusion criteria: * patients \< 1 year of age * patients who have previously received recombinant erwinia asparaginase within the past two weeks